This topic is about a person experiencing persistent stabbing pain near their ileostomy stoma. They are unsure if the pain is due to a hernia, adhesions, or something else. Here are some insights and advice that might be helpful:

- The person has had an ileostomy since December 6, 2021, after undergoing 11 surgeries in 11 weeks. A few months post-surgery, they began experiencing a stabbing pain about an inch to the right of the stoma. This pain has intensified over time, ranging from a dull ache to severe stabbing and occasional burning.

- A surgeon suggested via voicemail that it might be "a bulge in the muscle" and advised not to worry unless a blockage occurs. However, no physical examination has been conducted.

- A stoma nurse suspects a parastomal hernia, although there is no visible bulge, and the skin appears healthy with no leakage during appliance changes.

- The person has been tracking their food and activity but hasn't identified any triggers for the pain.

- They have avoided visiting the emergency room due to previous traumatic experiences, including being sent home shortly before a bowel perforation.

- The next surgical review is scheduled as a telephone appointment on December 7, with no physical examination planned.

- The general practitioner has only prescribed co-codamol tablets, which have not relieved the pain.

- The person is seeking ideas on what the pain could be and how to get it properly investigated.

Additional considerations include:

- They wonder if scar adhesions could be causing the stabbing pain.

- They are considering formal complaints or legal action, believing that earlier attention might have prevented the need for a permanent stoma.

- They plan to try writing a letter to their GP or surgeon after poor results from phone consultations.

Advice and insights offered include:

1. Do not hesitate to visit the emergency room when the pain is severe. Remind triage staff of past experiences where dismissal led to serious complications, and be assertive to prevent a repeat of past mistakes.

2. Writing letters or emails to the GP, surgeon, and stoma nurse documenting symptoms, dates, and previous contacts can often prompt faster action. These also create a paper trail that could be useful if legal action becomes necessary.

3. Possible causes of the pain include:
- A parastomal hernia, which may be internal without a visible bulge.
- Scar tissue or adhesions from multiple surgeries, which might require surgical removal.
- Strictures or ongoing healing issues.
- Retained surgical material, such as non-dissolved sutures, which can cause localized stabbing pain.
- Undiagnosed cysts or other growths, as misdiagnosis can lead to emergency surgery.

4. Imaging tests like CT scans or ultrasounds, along with a hands-on physical examination, are recommended to identify hernias, adhesions, or retained materials. Painkillers alone are not sufficient.

5. Keeping a detailed pain diary and copies of all correspondence is important. If a complaints procedure is initiated, every written record strengthens the case.

6. If doctors dismiss concerns, seek a second opinion promptly. Early investigation can prevent conditions from worsening or the need for additional surgery.